Reducing maternal mortality: Can we derive policy guidance from developing country experiences

被引:23
作者
Liljestrand, J [1 ]
Pathmanathan, I [1 ]
机构
[1] Lund Univ, Malmo Univ Hosp, Dept Community Med, SE-20502 Malmo, Sweden
关键词
D O I
10.1057/palgrave.jphp.3190030
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Developing countries are floundering in their efforts to meet the Millennium Development Goal of reducing maternal mortality by 75% by 2015. Two issues are being debated. Is it doable within this time frame? And is it affordable? Malaysia and Sri Lanka have in the past 50 years repeatedly halved their maternal mortality ratio (MMR) every 7-10 years to reduce MMR from over 500 to below 50. Experience from four other developing countries-Bolivia, Yunan in China, Egypt, and Jamaica-confirms that each was able to halve MMR in less than 10 years beginning from levels Of 200-300. Malaysia and Sri Lanka, invested modestly (but wisely)-less than 0.4% of GDP-on maternal health throughout the period of decline, although the large majority of women depended on publicly funded maternal health care. Analysis of their experience suggests that provision of access to and removal of barriers for the use of skilled birth attendance has been the key. This included professionalization of midwifery and phasing out of traditional birth attendants; monitoring births and maternal deaths and use of such information for high profile advocacy on the importance of reducing maternal death; and addressing critical gaps in the health system; and reducing disparities between different groups through special attention to the poor and disadvantaged populations.
引用
收藏
页码:299 / 314
页数:16
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